PACIO Advance Directive Interoperability Implementation Guide
2.1.0 - STU 2
PACIO Advance Directive Interoperability Implementation Guide
2.1.0 - STU 2
PACIO Advance Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-adi/ and changes regularly. See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "PMO-Example-Smith-Johnson-Bundle2",
"identifier" : {
"system" : "urn:oid:2.16.840.1.113883.3.3208.101.1"
},
"type" : "document",
"timestamp" : "2024-03-29T14:25:34.001-05:00",
"entry" : [
{
"fullUrl" : "http://www.example.org/fhir/Composition/PMO-Example-Smith-Johnson-PMOComposition1",
"resource" : {
"resourceType" : "Composition",
"id" : "PMO-Example-Smith-Johnson-PMOComposition1",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOComposition"
]
},
"language" : "en-US",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><a name=\"Composition_PMO-Example-Smith-Johnson-PMOComposition1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Composition PMO-Example-Smith-Johnson-PMOComposition1</b></p><a name=\"PMO-Example-Smith-Johnson-PMOComposition1\"> </a><a name=\"hcPMO-Example-Smith-Johnson-PMOComposition1\"> </a><a name=\"PMO-Example-Smith-Johnson-PMOComposition1-en-US\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en-US</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ADI-PMOComposition.html\">ADI PMO Composition</a></p></div><p><b>Composition Version Number</b>: 11546d53-a054-4882-bc0a-ff02aa0ba887c</p><p><b>Jurisdiction</b>: <span title=\"Codes:{urn:iso:std:iso:3166:-2 US-MI}\">Michigan (United States)</span></p><p><b>Data Enterer</b>: <a href=\"Patient-Example-Smith-Johnson-Patient1.html\">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#10A3D58WH1600)</a></p><p><b>Effective Date</b>: 2024-03-29 14:25:34-0500 --> (ongoing)</p><p><b>identifier</b>: <code>urn:oid:2.16.840.1.113883.4.823.1.7124</code>/0-87f37989294a408897aacd1fc5d8fd16</p><p><b>status</b>: Final</p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 93037-0}\">Portable medical order form</span></p><p><b>category</b>: <span title=\"Codes:{http://loinc.org 42348-3}\">Advance directives</span></p><p><b>date</b>: 2024-03-29 14:25:34-0500</p><p><b>author</b>: <a href=\"PractitionerRole-Example-Kyle-Anydoc-PractitionerRole1.html\">PractitionerRole</a></p><p><b>title</b>: Portable Medical Order</p><p><b>custodian</b>: <a href=\"Organization-Example-Smith-Johnson-OrganizationCustodian1.html\">Organization MyDirectives.com</a></p></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/composition-clinicaldocument-versionNumber",
"valueString" : "11546d53-a054-4882-bc0a-ff02aa0ba887c"
},
{
"url" : "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-jurisdiction-extension",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "urn:iso:std:iso:3166:-2",
"code" : "US-MI"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-dataEnterer-extension",
"valueReference" : {
🔗 "reference" : "Patient/Example-Smith-Johnson-Patient1"
}
},
{
"url" : "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-effective-date-extension",
"valuePeriod" : {
"start" : "2024-03-29T14:25:34-05:00"
}
}
],
"identifier" : {
"system" : "urn:oid:2.16.840.1.113883.4.823.1.7124",
"value" : "0-87f37989294a408897aacd1fc5d8fd16"
},
"status" : "final",
"type" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "93037-0",
"display" : "Portable medical order form"
}
]
},
"category" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "42348-3",
"display" : "Advance directives"
}
]
}
],
"subject" : {
🔗 "reference" : "Patient/Example-Smith-Johnson-Patient1"
},
"date" : "2024-03-29T14:25:34-05:00",
"author" : [
{
🔗 "reference" : "PractitionerRole/Example-Kyle-Anydoc-PractitionerRole1"
}
],
"title" : "Portable Medical Order",
"custodian" : {
🔗 "reference" : "Organization/Example-Smith-Johnson-OrganizationCustodian1"
},
"section" : [
{
"title" : "Portable Medical Orders",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "59772-4"
}
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>PMO Medical Orders</b></p><p><i>Order Exists: <a href=\"http://www.example.com\">available here</a></i></p></div>"
},
"entry" : [
{
🔗 "reference" : "ServiceRequest/Example-Smith-Johnson-CPR-ServiceRequest1"
}
]
},
{
"title" : "Additional Documentation",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "77599-9"
}
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>PMOLST Order Observation</b></p><p><i>Order Exists: <a href=\"http://www.example.com\">available here</a></i></p></div>"
},
"entry" : [
{
🔗 "reference" : "Observation/Example-Smith-Johnson-DocumentationObservation1"
}
]
},
{
"title" : "Witnesses and Notary",
"code" : {
"coding" : [
{
"system" : "http://loinc.org",
"code" : "81339-4",
"display" : "Witness and Notary Document"
}
]
},
"text" : {
"status" : "additional",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>I am emotionally and mentally competent to make this uADD. I understand the purpose and effect of this uADD, I agree with everything that is written in this uADD, and I have made this uADD knowingly, willingly and after careful deliberation.</p><table><tbody><tr><td><b>Signature:</b></td><td>Betsy Smith-Johnson</td></tr><tr><td><b>Date:</b></td><td>3/29/2024</td></tr></tbody></table><p></p><p><b>Statement of Witnesses</b></p><p></p><p>I declare that the person who signed this uADD, or who asked another to sign this uADD on his/her behalf, is the individual identified in the document, and he/she did so in my presence or otherwise provided satisfactory proof to me of his/her identity. I believe him/her to be of sound mind and at least 18 years of age. I personally witnessed him/her sign this document or ask the person indicated to do so, or I received proof of his/her identity that I believe is adequate, and I believe that he/she did so voluntarily. By signing this document as a witness, I certify that I am:</p><p></p><ul><li>At least 18 years of age.</li><li>Not related to the person signing this document by blood, marriage or adoption.</li><li>Not a healthcare agent appointed by the person signing this document.</li><li>Not directly financially responsible for that person’s healthcare.</li><li>Not a healthcare provider directly serving the person at this time.</li><li>Not an employee (other than a social worker or chaplain), officer, director, or partner of a healthcare provider (or any parent organization of such healthcare provider) directly serving the person at this time.</li><li>Not aware that I am entitled to or have a claim against the person’s estate.</li></ul><p></p><table><tbody><tr><td><b>Witness Number:</b></td><td></td></tr><tr><td><b>Signature:</b></td><td></td></tr><tr><td><b>Date:</b></td><td></td></tr></tbody></table></div>"
}
}
]
}
},
{
"fullUrl" : "http://www.example.org/fhir/Patient/Example-Smith-Johnson-Patient1",
"resource" : {
"resourceType" : "Patient",
"id" : "Example-Smith-Johnson-Patient1",
"meta" : {
"lastUpdated" : "2021-03-29T14:25:34.001-05:00",
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
]
},
"language" : "en-US",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><a name=\"Patient_Example-Smith-Johnson-Patient1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient Example-Smith-Johnson-Patient1</b></p><a name=\"Example-Smith-Johnson-Patient1\"> </a><a name=\"hcExample-Smith-Johnson-Patient1\"> </a><a name=\"Example-Smith-Johnson-Patient1-en-US\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Last updated: 2021-03-29 14:25:34-0500; Language: en-US</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-patient.html\">US Core Patient Profile</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#10A3D58WH1600)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td>true</td><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}\">unknown</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Other Id (see the one above)\">Other Id:</td><td colspan=\"3\">Medical Record Number/1032702\u00a0(use:\u00a0usual,\u00a0)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li><a href=\"mailto:BetsySJ@example.com\">BetsySJ@example.com</a></li><li>111 Maple Court San Antonio TX 78212 US (home)</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Language spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes:{urn:ietf:bcp:47 en}\">English</span> (preferred)</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Nominated Contact: son\">son:</td><td colspan=\"3\"><ul><li>Charles Johnson</li><li>111 Maple Ct, Grand Rapids, MI 49503</li><li>ph: (210) 222-3333</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Nominated Contact: daughter\">daughter:</td><td colspan=\"3\"><ul><li>Debra Johnson</li><li>333 W. Camden St., Baltimore, MD 21201</li><li>ph: (410) 444-5555</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Concepts classifying the person into a named category of humans sharing common history, traits, geographical origin or nationality. The race codes used to represent these concepts are based upon the [CDC Race and Ethnicity Code Set Version 1.0](http://www.cdc.gov/phin/resources/vocabulary/index.html#3) which includes over 900 concepts for representing race and ethnicity of which 921 reference race. The race concepts are grouped by and pre-mapped to the 5 OMB race categories:\n\n - American Indian or Alaska Native\n - Asian\n - Black or African American\n - Native Hawaiian or Other Pacific Islander\n - White.\">US Core Race Extension:</td><td colspan=\"3\"><ul><li>ombCategory: CDC Race and Ethnicity 2106-3: White</li><li>text: White</li></ul></td></tr></table></div>"
},
"extension" : [
{
"extension" : [
{
"url" : "ombCategory",
"valueCoding" : {
"system" : "urn:oid:2.16.840.1.113883.6.238",
"code" : "2106-3",
"display" : "White"
}
},
{
"url" : "text",
"valueString" : "White"
}
],
"url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race"
}
],
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MR",
"display" : "Medical Record Number"
}
],
"text" : "Medical Record Number"
},
"system" : "http://hospital.smarthealthit.org",
"value" : "1032702"
},
{
"system" : "http://hl7.org/fhir/sid/us-medicare",
"value" : "10A3D58WH1600"
}
],
"active" : true,
"name" : [
{
"use" : "usual",
"text" : "Smith-Johnson, Betsy",
"family" : "Smith-Johnson",
"given" : [
"Betsy"
]
}
],
"telecom" : [
{
"system" : "email",
"value" : "BetsySJ@example.com",
"use" : "home"
}
],
"gender" : "female",
"birthDate" : "1950-11-15",
"address" : [
{
"use" : "home",
"type" : "physical",
"line" : [
"111 Maple Court"
],
"city" : "San Antonio",
"state" : "TX",
"postalCode" : "78212",
"country" : "US"
}
],
"maritalStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
"code" : "UNK"
}
]
},
"contact" : [
{
"relationship" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "SONC"
}
]
}
],
"name" : {
"text" : "Charles Johnson"
},
"telecom" : [
{
"system" : "phone",
"value" : "(210) 222-3333"
}
],
"address" : {
"text" : "111 Maple Ct, Grand Rapids, MI 49503"
}
},
{
"relationship" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code" : "DAUC"
}
]
}
],
"name" : {
"text" : "Debra Johnson"
},
"telecom" : [
{
"system" : "phone",
"value" : "(410) 444-5555"
}
],
"address" : {
"text" : "333 W. Camden St., Baltimore, MD 21201"
}
}
],
"communication" : [
{
"language" : {
"coding" : [
{
"system" : "urn:ietf:bcp:47",
"code" : "en",
"display" : "English"
}
]
},
"preferred" : true
}
]
}
},
{
"fullUrl" : "http://www.example.org/fhir/Patient/Example-Kyle-Anydoc-PractitionerRole1",
"resource" : {
"resourceType" : "PractitionerRole",
"id" : "Example-Kyle-Anydoc-PractitionerRole1",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PractitionerRole_Example-Kyle-Anydoc-PractitionerRole1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: PractitionerRole Example-Kyle-Anydoc-PractitionerRole1</b></p><a name=\"Example-Kyle-Anydoc-PractitionerRole1\"> </a><a name=\"hcExample-Kyle-Anydoc-PractitionerRole1\"> </a><a name=\"Example-Kyle-Anydoc-PractitionerRole1-en-US\"> </a><p><b>practitioner</b>: <a href=\"Practitioner-Example-Kyle-Anydoc-Practitioner.html\">Practitioner Kyle Anydoc </a></p></div>"
},
"practitioner" : {
🔗 "reference" : "Practitioner/Example-Kyle-Anydoc-Practitioner"
}
}
},
{
"fullUrl" : "http://www.example.org/fhir/Patient/Example-Kyle-Anydoc-Practitioner",
"resource" : {
"resourceType" : "Practitioner",
"id" : "Example-Kyle-Anydoc-Practitioner",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_Example-Kyle-Anydoc-Practitioner\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner Example-Kyle-Anydoc-Practitioner</b></p><a name=\"Example-Kyle-Anydoc-Practitioner\"> </a><a name=\"hcExample-Kyle-Anydoc-Practitioner\"> </a><a name=\"Example-Kyle-Anydoc-Practitioner-en-US\"> </a><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.4.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/21548796354</p><p><b>name</b>: Kyle Anydoc </p><p><b>telecom</b>: <a href=\"mailto:kanydoc@example.org\">kanydoc@example.org</a></p><p><b>address</b>: 567 Healthcare Drive Anytown MA 12345 US (home)</p><p><b>gender</b>: Male</p><h3>Qualifications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0360 MD}\">Doctor of Medicine</span></td></tr></table></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "21548796354"
}
],
"name" : [
{
"family" : "Anydoc",
"given" : [
"Kyle"
],
"prefix" : [
"Dr."
]
}
],
"telecom" : [
{
"system" : "email",
"value" : "kanydoc@example.org",
"use" : "work"
}
],
"address" : [
{
"use" : "home",
"line" : [
"567 Healthcare Drive"
],
"city" : "Anytown",
"state" : "MA",
"postalCode" : "12345",
"country" : "US"
}
],
"gender" : "male",
"qualification" : [
{
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0360",
"code" : "MD",
"display" : "Doctor of Medicine"
}
]
}
}
]
}
},
{
"fullUrl" : "http://www.example.org/fhir/Patient/Example-Smith-Johnson-CPR-ServiceRequest1",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "Example-Smith-Johnson-CPR-ServiceRequest1",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PMOCPRServiceRequest"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_Example-Smith-Johnson-CPR-ServiceRequest1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest Example-Smith-Johnson-CPR-ServiceRequest1</b></p><a name=\"Example-Smith-Johnson-CPR-ServiceRequest1\"> </a><a name=\"hcExample-Smith-Johnson-CPR-ServiceRequest1\"> </a><a name=\"Example-Smith-Johnson-CPR-ServiceRequest1-en-US\"> </a><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>category</b>: <span title=\"Codes:{http://loinc.org 100822-6}\">Cardiopulmonary resuscitation orders</span></p><p><b>doNotPerform</b>: true</p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 89666000}\">Cardiopulmonary resuscitation (procedure)</span></p><p><b>orderDetail</b>: <span title=\"Codes:{http://loinc.org LA33470-8}\">Yes CPR</span></p><p><b>subject</b>: <a href=\"Patient-Example-Smith-Johnson-Patient1.html\">Smith-Johnson, Betsy Female, DoB: 1950-11-15 ( http://hl7.org/fhir/sid/us-medicare#United States Medicare Number#10A3D58WH1600)</a></p><p><b>requester</b>: <a href=\"Practitioner-Example-Kyle-Anydoc-Practitioner.html\">Practitioner Kyle Anydoc </a></p></div>"
},
"status" : "active",
"intent" : "order",
"category" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "100822-6",
"display" : "Cardiopulmonary resuscitation orders"
}
]
}
],
"doNotPerform" : true,
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "89666000",
"display" : "Cardiopulmonary resuscitation (procedure)"
}
]
},
"orderDetail" : [
{
"coding" : [
{
"system" : "http://loinc.org",
"code" : "LA33470-8"
}
]
}
],
"subject" : {
🔗 "reference" : "Patient/Example-Smith-Johnson-Patient1"
},
"requester" : {
🔗 "reference" : "Practitioner/Example-Kyle-Anydoc-Practitioner"
}
}
}
]
}
IG © 2021+ HL7 International / Patient Empowerment. Package hl7.fhir.us.pacio-adi#2.1.0 based on FHIR 4.0.1. Generated 2024-11-01
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